MEDICARE: LABORATORY CORPORATION OF AMERICA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1346323011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABORATORY CORPORATION OF AMERICA

Provider Business Mailing Address
First Line	:	PO BOX 2240
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27216-2240
Country	:	US
Telephone Number	:	800-222-7566
Fax Number	:	336-436-1048

Provider Business Practice Location Address
First Line	:	1764 E ROUTE 66
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86004-5139
Country	:	US
Telephone Number	:	928-773-2575
Fax Number	:

Authorized Official
Title or Position	:	CFO/EVP TREASURER
Name	:	WILLIAM B HAYES
Credential	:
Telephone Number	:	800-222-7566

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	08/17/2007

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